We looked at serum lactate levels as a predictor of poor outcomes after cardiac surgery. The goal of this study was to see if a high blood lactate level after cardiac surgery is a predictor of early outcome after adult cardiac surgery with cardiopulmonary bypass.
Material and methods: Between September 2020 and November 2022, this research was done. It is a prospective cohort study consisting of 100 patients who were split into two groups: group 1 had high lactate levels equivalent to or greater than 4 mmol, while group 2 had lower lactate levels. Using a conventional arterial blood gas analyzer, the peak intraoperative blood lactate level was determined (GEM Premier 3000 Blood Gas Analyzer). Both groups' outcomes were contrasted and examined. Age, gender, hypertension, NYHA classification, and COPD were not significantly different between the two groups. BMI, diabetes mellitus, and smoking are all significantly higher in group I patients.
Results. Regarding intraoperative findings, including total cardiopulmonary bypass time, cross clamp time, hemoglobin level on bypass the study showed that Group I had a noticeably longer cross-clamp time (77 ±22 vs. 64 26; P = 0.043). But, when they were on pump, their hemoglobin was significantly lower (7.81±.1 vs. 8.50±.9, P = 0.011). Cardiopulmonary bypass (CPB) time was not significantly different (P = 0.115). Regarding postoperative findings that include atrial fibrillation, ventilation hours, length of ICU and complications in the form of renal failure and mortality, the study showed Group 1 patients with high peak lactate had significantly higher AF (39.8% vs. 0%, P = 0.001), ventilation hours (median = 24 vs. 8 hours, P = 0.001), renal dysfunction (26.5% vs. 0%, P = 0.016), length of ICU stay (median = 4 vs. 2 days, P = 0.001), and mortality (28.9% vs. Nil and p=0.011).
Conclusion: Hyperlactatemia was found to be significantly associated with post-operative morbidity. When discovered during the perioperative, hyperlactemia should be treated immediately as a sign of insufficient tissue oxygen delivery.
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